LIVER-TRANSPLANTATION FOR THE TREATMENT OF FULMINANT HEPATIC-FAILURE INDUCED BY THE INGESTION OF ECSTASY

Methylenedimethoxy-methamphetamine (MDMA), more commonly known as ecst asy, is a synthetic amphetamine derivative used by teenagers and young adults in the United States as well as in Western Europe as a ''dance drug'', Though a number of complications associated with this drug ha ve been reported, there is little information pertaining to hepatoxity as a result of MDMA ingestion. This case report is about an 18-year-o ld female patient who regularly used ecstasy on weekends over a 2-mont h period. Within 2 days after accepting a ''hit'' of the substance at a party, she was admitted to the hospital because of lethargy, vomitin g, abdominal pain, stool discoloration, icterus, and darkened urine, O n day 7 she developed fulminant hepatic failure with reduced hepatic c oagulation factors and grade IV encephalopathy. Orthotopic liver trans plantation was carried out 10 days following the ingestion. The patien t made a full recovery within 72 h and was released from the hospital 6 weeks later. Histopathological examination of the removed liver reve aled a nutritive-toxic liver necrosis. This case demonstrates that the ingestion of ecstacy, even on an infrequent basis, can lead to acute fulminant liver necrosis, and that this life-threatening complication can be treated successfully by liver transplantation.